Posterior capsular plaque: A common feature of cataract surgery in the developing world

PURPOSE: To study the histopathologic findings of posterior capsular plaque, a lesion that is discovered frequently in eyes undergoing cataract surgery in the developing world. METHODS: Two hundred human crystalline lenses removed from 200 eyes of 200 patients who underwent intracapsular cataract extraction at Sagarmatha Choudhary Eye Hospital in Nepal were analyzed histopathologically. RESULTS: Forty-nine lenses (24.5%) had a posterior capsular plaque. We confirm that the posterior plaques are composed of collagen that stains positively for Masson trichrome stain and that forms after pseudofibrous metaplasia of lens cells along the posterior capsule. The plaques form in a fashion analogous to a healing process. CONCLUSIONS: We postulate that posterior capsular plaques result from posterior migration of epithelium and pseudofibrous metaplasia of lens epithelium. Most of the posterior capsular plaques are minute and not likely to affect vision. However, a small percentage of plaques are thicker and are likely to impair vision after extracapsular cataract surgery. (C) 1998 by Elsevier Science Inc. All rights reserved.